| NPI | 1962968503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO216762) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 7019) |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2023-09-11 |