| NPI | 1407897705 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 43104-020) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 43104-020) | 
| Enumeration Date | 2006-06-09 | 
| Last Update Date | 2018-03-17 |