| NPI | 1174935712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 62066) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R-10002) |
| 207P00000X Emergency Medicine (Licence: WI 82203-21) | |
| 207P00000X Emergency Medicine (Licence: IA DO-04811) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2026-06-02 |