| NPI | 1104154665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 18611) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX M0032) |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2020-11-10 |