| NPI | 1841970233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 023538) |
| Additional Taxonomies | 261QS1000X Clinic/Center Student Health (Licence: PR 16168) |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2023-10-18 |