| NPI | 1528515210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 9183384) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: FL 9183384) |
| 261QP2300X Clinic/Center, Primary Care (Licence: FL 9183384) | |
| 275N00000X Medicare Defined Swing Bed Unit (Licence: FL 9183384) | |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2020-11-15 |