| NPI | 1104037159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD.MD61263658) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.097143) |
| 207Q00000X Family Medicine (Licence: MO 2005029301) | |
| 207Q00000X Family Medicine (Licence: CA A120030) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2025-06-23 |