| NPI | 1114247566 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME DO2537)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT013357)  | 
| 207R00000X Internal Medicine (Licence: PA OT013357)  | |
| 207P00000X Emergency Medicine (Licence: PA OS015723)  | |
| Enumeration Date | 2010-06-08 | 
| Last Update Date | 2019-04-16 |