| NPI | 1104871565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301057743) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301057743) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2025-10-27 |