| NPI | 1164578910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX J7273) |
| Additional Taxonomies | 171W00000X Contractor (Licence: TX J7273) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2023-08-14 |