| NPI | 1265875686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 300062) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 300062) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2020-05-06 |