| NPI | 1376534115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA AP30007038) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA RN00074219) |
| Enumeration Date | 2005-11-01 |
| Last Update Date | 2009-10-07 |