| NPI | 1558992149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR 122834) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 102811) |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-09-18 |