| NPI | 1861597197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 12816) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-0674) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-07-08 |