| NPI | 1598810996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: KY 29709) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01053590A) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2023-02-09 |