| NPI | 1942963038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1423) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21707) |
| Enumeration Date | 2021-10-16 |
| Last Update Date | 2025-07-28 |