| NPI | 1659990489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: MN 77900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02009036A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-12 |
| Last Update Date | 2026-04-21 |