| NPI | 1649617440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 255492) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM A-1998-16) |
| 207P00000X Emergency Medicine (Licence: NH 33315) | |
| 207P00000X Emergency Medicine (Licence: VT 032.0134210) | |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2025-03-31 |