| NPI | 1336545375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN-849) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 18930) |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2018-04-18 |