| NPI | 1669815148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: WA MD60830944) |
| Additional Taxonomies | 2088P0231X (Licence: WA MD60830944) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2020-10-13 |