| NPI | 1174040497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1086) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 019966) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 14321-I) | |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2022-03-25 |