| NPI | 1164844577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A14890) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2022-08-01 |