| NPI | 1477860153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 14643) |
| Additional Taxonomies | 208D00000X General Practice (Licence: ZZ JUR.No.10404) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2010-09-22 |