| NPI | 1962022152 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1425) | 
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21878) | 
| Enumeration Date | 2020-04-17 | 
| Last Update Date | 2022-07-25 |