| NPI | 1134196207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 15679) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: OK 15679) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2014-01-06 |