| NPI | 1710154109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P2586) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX P2586) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2025-09-30 |