| NPI | 1245737758 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1362)  | 
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21454)  | 
| Enumeration Date | 2018-04-11 | 
| Last Update Date | 2022-11-01 |