| NPI | 1790002301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN788) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 17868) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2022-11-14 |