| NPI | 1114904943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 15207) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 77113) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2024-07-18 |