| NPI | 1578296844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL 1571) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 023427) |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2024-06-14 |