| NPI | 1548409733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A119819) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301092570) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2015-06-08 |