| NPI | 1700291689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: WA MD60459923) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA 60459923) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2022-02-15 |