NPI | 1023390507 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WY TL8682) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R79477) |
363A00000X Physician Assistant (Licence: MI 5601006114) | |
Enumeration Date | 2011-09-12 |
Last Update Date | 2025-07-01 |