| NPI | 1043418239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60781418) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 30872) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2022-10-26 |