| NPI | 1508183146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 37079) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 53087) |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2020-09-23 |