| NPI | 1790429009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 98906) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI MD-26116) |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2026-06-23 |