| NPI | 1043288822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 19503) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01075874A) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2022-02-04 |