NPI | 1124438015 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60750074) |
Additional Taxonomies | 208D00000X General Practice (Licence: WA 60750074) |
Enumeration Date | 2014-05-01 |
Last Update Date | 2022-07-20 |