| NPI | 1508252396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ACN1160) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 18956) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2019-12-19 |