| NPI | 1518380922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 28031) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A146531) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2024-07-22 |