| NPI | 1164656922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 79767) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2011-00522) |
| 207P00000X Emergency Medicine (Licence: FL ME142156) | |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2020-05-05 |