| NPI | 1629090600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 80607) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 28155) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MA 80607) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-01-25 |