| NPI | 1639282494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 16496) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ACN1320) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2022-06-22 |