| NPI | 1306392451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1107) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 19738) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN28885) | |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2021-07-26 |