| NPI | 1275979361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 84465) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 26527) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2020-12-01 |