| NPI | 1912014374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 26370) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L7747) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2011-06-06 |