| NPI | 1457162398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL 1697) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 24197) |
| Enumeration Date | 2025-01-20 |
| Last Update Date | 2025-09-30 |