| NPI | 1609308881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 6142) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 0125R) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2020-10-16 |