| NPI | 1760765762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME145313) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ACN482) |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2023-04-28 |