| NPI | 1104384726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2022-01713) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AZ 61377) |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2025-07-15 |