| NPI | 1144261934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 1506) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OK 1506) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2017-07-14 |