| 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 |