| NPI | 1154708386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 019967) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 133209) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2021-03-30 |