| NPI | 1649279860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: WA MD00041919) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA 025209MD00041909) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2009-08-05 |