| NPI | 1831755677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL 1346) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21764) |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2021-06-29 |