| NPI | 1386054336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 79279) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60405498) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2022-08-22 |