| NPI | 1548783632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 21338) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 33307R) |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2019-08-15 |