| NPI | 1821762642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 22511) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ACN1375) |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2021-10-12 |