| NPI | 1013204205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301104667) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT200155) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: MI 4301104667) | |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2015-09-21 |