| NPI | 1811936412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 15242) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 24276) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2018-07-11 |