| NPI | 1881817666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 9465A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WY TL2271) |
| 207Q00000X Family Medicine (Licence: OK 4903) | |
| 207Q00000X Family Medicine (Licence: CO DR.0052275) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2014-12-18 |