| NPI | 1043674880 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1185)  | 
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 81821)  | 
| Enumeration Date | 2016-04-07 | 
| Last Update Date | 2022-09-14 |