| NPI | 1831551084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: WA 61013270) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WI 6772620) |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2020-08-18 |