| NPI | 1518712793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL 09597964) |
| Additional Taxonomies | 251K00000X Public Health or Welfare (Licence: FL 18148) |
| Enumeration Date | 2024-04-20 |
| Last Update Date | 2024-06-17 |