| NPI | 1033391370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 28017) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OK 28017) |
| 207Q00000X Family Medicine (Licence: NY 263278) | |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2025-08-01 |