| NPI | 1942289939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 10956) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX E4569) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2010-01-22 |