| NPI | 1336180488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care (Licence: TN 41772) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 195273) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2016-07-11 |