| NPI | 1639665664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1438) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21032) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2022-08-12 |