| NPI | 1255441143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 20A11995) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AZ 3595) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2025-04-16 |