| NPI | 1750547469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 268839) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.095813) |
| 207Q00000X Family Medicine (Licence: OK 25701) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2021-03-08 |