| NPI | 1306897764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1125) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 16289) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2024-01-25 |