| NPI | 1720174873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 58478) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 2002456A) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2013-07-26 |