| NPI | 1598901621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 29968) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: WA 29968) |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2008-12-18 |