| NPI | 1508883059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 19220) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 19220) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2022-02-17 |