| NPI | 1962631713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 17634) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ACN1406) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2026-01-14 |