| NPI | 1295964823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 4800) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2011-00671) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2019-11-12 |