| NPI | 1538626940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 21698) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 14981-I) |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2020-07-02 |