| NPI | 1053799965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 112708) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ZZ 112708) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA ML60572504) | |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2021-05-05 |