| NPI | 1770840795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 5437) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S8491) |
| Enumeration Date | 2012-04-15 |
| Last Update Date | 2022-08-08 |