| NPI | 1699796862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2015-0876) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 21795) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2016-04-27 |