| NPI | 1609959469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL 1285) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 16626) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2021-12-07 |