| NPI | 1124234034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1168) |
| Additional Taxonomies | 261QE0002X Clinic/Center Emergency Care |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2021-06-11 |