| NPI | 1154313120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 8737) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 03511) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2024-10-24 |