| NPI | 1548835374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 206125) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR 202101364NP-PP) |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2023-01-09 |