| NPI | 1538694757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 41123) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: SC 41123) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2020-07-08 |