| NPI | 1790006591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 29726) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11015402A) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2016-08-25 |