| NPI | 1093054520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA NT60321386) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA 40716) |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2013-02-04 |