| NPI | 1720128648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 49518) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 51882-20) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2024-11-05 |