| NPI | 1932546546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME155244) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301114482) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2023-07-21 |