| NPI | 1619922416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 30873) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-25854) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2014-09-03 |