| NPI | 1649566720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 30796) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-7897) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2014-12-30 |