| NPI | 1659912855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR 225970) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 109477) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2023-10-10 |