| NPI | 1942624036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME136951) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ACN 540) |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2025-10-09 |