| NPI | 1073659702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1353) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 11903) |
| 208000000X Pediatrics (Licence: FL ACN1353) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2022-06-13 |