| NPI | 1407029903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202D00000X (Licence: WA OP00001238) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP00001238) |
| 208D00000X General Practice (Licence: WA OP00001238) | |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2022-12-06 |