| NPI | 1366638249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 4301115801) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ACN1351) |
| 208D00000X General Practice (Licence: PR 16880) | |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2024-02-29 |