| NPI | 1871229047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: WA MDCE.ML.61331468) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MDCE.ML.61331468) |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2022-07-28 |