| NPI | 1316200124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60409594) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL60288895) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2016-02-24 |