| NPI | 1396860326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 12377) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: PR 12377) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2022-05-13 |