| NPI | 1023512563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 79953) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 65865) |
| 207P00000X Emergency Medicine (Licence: MN 29159) | |
| 207P00000X Emergency Medicine (Licence: WI 75319) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2025-06-16 |