| NPI | 1124221593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1152) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 14586) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2022-03-23 |