| NPI | 1790702389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 26656) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G77816) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-10-19 |