| NPI | 1639103559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS9742) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 18836) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2017-05-12 |