| NPI | 1770922254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101260575) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 29915) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2023-05-10 |