| NPI | 1073650693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00027849) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WA MD00027849) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2018-05-31 |