| NPI | 1972564052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 11538) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 11538) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2017-07-24 |