| NPI | 1740545581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 70250) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 59058) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2023-03-06 |