| NPI | 1164914511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 009093) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AZ 009093) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2023-04-28 |