| NPI | 1104177179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 49804) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY TP495) |
| 208600000X Surgery (Licence: PA MT202590) | |
| 282N00000X General Acute Care Hospital (Licence: KY IP1398) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY R3680) | |
| Enumeration Date | 2012-09-30 |
| Last Update Date | 2016-12-19 |