| NPI | 1790957538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN695) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 17062) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2023-03-07 |