| NPI | 1558707976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 17685) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A151391) |
| 207Q00000X Family Medicine (Licence: OK 30041) | |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2018-11-15 |