| NPI | 1902366719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME171615) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 021422) |
| 208D00000X General Practice (Licence: FL ACN1174) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-10-09 |