| NPI | 1265839633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 61095) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 19118) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2025-04-11 |