| NPI | 1285251595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 22409) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 15358-I) |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2021-07-28 |