| NPI | 1972833754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N8909) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 27109) |
| 281P00000X Chronic Disease Hospital (Licence: OK 27109) | |
| 282N00000X General Acute Care Hospital (Licence: OK 27109) | |
| Enumeration Date | 2009-12-30 |
| Last Update Date | 2021-10-29 |