| NPI | 1699493742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: SC 89845) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX W8291) |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2026-08-27 |