| NPI | 1174569156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: OR MD20308) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD20308) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2010-11-03 |