| NPI | 1184911703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301098626) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 57700) |
| 208D00000X General Practice (Licence: MN 57700) | |
| Enumeration Date | 2011-07-03 |
| Last Update Date | 2020-12-04 |