| NPI | 1386630945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 20A10018) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL os8327) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2024-04-12 |