| NPI | 1083781140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA WAMD24478) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: WA WAMD24478) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-08-01 |