| NPI | 1346658838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60951407) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA LIERMCJ127LT) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2020-12-08 |