| NPI | 1831754555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME174384) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 22163) |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2025-06-24 |