| NPI | 1538491899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: WY 5388A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 15901) |
| Enumeration Date | 2010-02-10 |
| Last Update Date | 2010-02-10 |