| NPI | 1205179280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 44540) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 4477) |
| 207R00000X Internal Medicine (Licence: OH 35-071114) | |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2013-03-28 |