| NPI | 1639119340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 13306) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ACN858) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2022-08-05 |