NPI | 1619153574 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 4553) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 36052) |
Enumeration Date | 2008-01-10 |
Last Update Date | 2021-12-10 |