| NPI | 1316771397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: WA MDCE.ML.61606251) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: MDCE.ML.61606251) |
| Enumeration Date | 2024-08-30 |
| Last Update Date | 2024-09-04 |