| NPI | 1336185362 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 073150)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 35905)  | 
| 207P00000X Emergency Medicine (Licence: NE 23512)  | |
| 207P00000X Emergency Medicine (Licence: WI 39266)  | |
| Enumeration Date | 2006-06-20 | 
| Last Update Date | 2013-03-25 |