| NPI | 1518497205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 13244489-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 271226) |
| 207PS0010X Emergency Medicine Sports Medicine (Licence: UT 13244489-1205) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2023-08-23 |