| NPI | 1972588440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 20285) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-10962) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2018-07-20 |