| NPI | 1396832390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 45827) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 20263) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2015-01-18 |