| NPI | 1861576761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60752475) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 047964) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-12-02 |