| NPI | 1538168505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 30460) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E3302) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2017-10-20 |