| NPI | 1811257983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 29222) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 29222) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2018-03-15 |