| NPI | 1538203856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NM 94-300) |
| Additional Taxonomies | 193200000X Multi-Specialty (Licence: NM 94-300) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2020-11-05 |