| NPI | 1386647766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 46452) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CO 35452) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2019-05-14 |