| NPI | 1073076246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 39520) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: AK 228217) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2026-03-16 |