| NPI | 1508169731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 9096) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2025016798) |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2025-06-04 |