| NPI | 1346625746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL 1400) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 19938) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2023-12-01 |