| NPI | 1679776199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 27541) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN11002) |
| 207Q00000X Family Medicine (Licence: FL ME106278) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2010-11-03 |