| NPI | 1154575090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: WA MD00044678) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WA MD000044678) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2022-02-11 |