| NPI | 1558370254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-14377) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 200121) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2021-08-31 |