| NPI | 1508448333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1376) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 022529) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 15636i) | |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2022-01-23 |