| NPI | 1750738308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 34503) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-08892) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2023-04-21 |