| NPI | 1699396077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 39709) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2021022684) |
| 208000000X Pediatrics (Licence: KS 94-10784) | |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2025-06-30 |