| NPI | 1053750430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP60726262) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101020424) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2019-01-24 |