| NPI | 1962708800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: WA MEDS7582) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60106786) |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2025-02-04 |