| NPI | 1164657375 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR 155139) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60617983) | 
| Enumeration Date | 2009-05-18 | 
| Last Update Date | 2022-02-04 |