| NPI | 1548268469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2019038701) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 21839) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2019-11-11 |