| NPI | 1619660396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1665) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 16-530-I) |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2024-10-17 |