| NPI | 1366145591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 74447) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 23143) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2025-03-25 |