| NPI | 1629012927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 36231) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101240639) |
| 207P00000X Emergency Medicine (Licence: NC 2007-00581) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2012-11-16 |