| 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 |