| NPI | 1801185277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MO 2012029298) |
| Additional Taxonomies | 208D00000X General Practice (Licence: KS 05-35969) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2015-12-01 |