| NPI | 1285976563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 63433) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 63433-20) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2021-11-24 |