| NPI | 1134563018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 20994) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 014556-I) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2013-09-30 |