| 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 |