| NPI | 1679663413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: WA MD0003235) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 73124) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-09-28 |