| NPI | 1639373426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 87164) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 24786) |
| 208D00000X General Practice (Licence: TN 58466) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2021-11-30 |