| NPI | 1932629268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 6489) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 0220R) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2020-07-13 |