| NPI | 1891795654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN646) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 13123) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2018-03-27 |