| NPI | 1861997561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 23109) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102207353) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2025-01-03 |