| NPI | 1639058795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 1639453582) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL 1932473170) |
| Enumeration Date | 2025-09-01 |
| Last Update Date | 2025-10-01 |