| NPI | 1023062239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 25368) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-31025) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2013-09-18 |