| NPI | 1629134952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN700) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 16116) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2025-08-21 |