| NPI | 1134502131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 79053) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 298524) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2025-07-08 |