| NPI | 1053738443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61022309) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA OP61022309) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2021-04-05 |