| NPI | 1386040954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME139667) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ACN609) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2025-03-10 |