| NPI | 1740855196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 22358) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 15-395I) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2021-07-06 |