| NPI | 1952715401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 30767) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 25513) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2024-04-24 |