| NPI | 1689148694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 22058) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 14968) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2021-04-22 |