| NPI | 1073789525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60111548) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WA MD60111548) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2011-04-01 |