| NPI | 1861455222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 40062) |
| Additional Taxonomies | 208D00000X General Practice (Licence: SC 15987) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2023-03-07 |