| NPI | 1689683179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2006-01163) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2006-01163) |
| 207P00000X Emergency Medicine (Licence: NC 200601163) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2021-08-19 |