| NPI | 1124382189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 39103) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC MD043377) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2022-09-08 |