| NPI | 1457691503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: PR 18557) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 18557) |
| 208D00000X General Practice (Licence: PR 18557) | |
| Enumeration Date | 2013-02-27 |
| Last Update Date | 2018-09-28 |