| NPI | 1528006590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 21010) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 104143) |
| 207Q00000X Family Medicine (Licence: KS 04-27866) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2014-09-25 |