| NPI | 1194971994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60514769) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101246182) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2019-03-01 |