| NPI | 1689107377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X (Licence: WA MD61274088) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD61274088) |
| 208D00000X General Practice (Licence: WA MD61274088) | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2023-11-09 |