| NPI | 1023302080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 28477) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 60463893) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2019-04-24 |