| NPI | 1922585397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 23167) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 35717) |
| 208D00000X General Practice (Licence: PR 35913) | |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2023-04-28 |