| NPI | 1710541859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 39062) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0075568) |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2026-05-21 |