| NPI | 1275529919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 40551) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P4403) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2023-01-12 |