| NPI | 1720203987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 53281) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 105069 temp permit) |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2022-07-01 |