| NPI | 1407909880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00040713) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WA MD00040713) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2015-05-04 |