| NPI | 1225069685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 6379A) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: WY 6379A) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2018-05-17 |