| NPI | 1235360819 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-7438) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60932350) | 
| Enumeration Date | 2009-07-31 | 
| Last Update Date | 2025-01-24 |