| NPI | 1811487564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61332409) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: WA OP61332409) |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2022-09-27 |