| NPI | 1932586468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 33600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 38429) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2020-11-17 |