| NPI | 1104053727 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: WA MD60225581)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: WA 60225581)  | 
| 207Q00000X Family Medicine (Licence: WA MD60225581)  | |
| Enumeration Date | 2009-06-22 | 
| Last Update Date | 2025-05-21 |