| NPI | 1205504693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 23005) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 15830-I) |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2023-03-08 |