| NPI | 1003128992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 56317) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 60782-20) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2020-02-27 |