| NPI | 1508126095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 139568) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL 139568) |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2025-07-30 |