| NPI | 1972538825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN 434) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 14430) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2015-06-03 |