| NPI | 1366645947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA ML20008318) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00048880) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2021-06-03 |