| NPI | 1699336214 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 21418) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 21418) | 
| Enumeration Date | 2019-06-25 | 
| Last Update Date | 2023-02-21 |