| NPI | 1265616809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL me106791) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 26076) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2016-12-05 |