| NPI | 1205021169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME161161) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 25742) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2023-06-26 |