| NPI | 1033141544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00046020) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00046020) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2016-02-04 |