| NPI | 1720223415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 94276) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T7518) |
| 207P00000X Emergency Medicine (Licence: AZ 51162) | |
| 207Q00000X Family Medicine (Licence: KS 0449744) | |
| 207P00000X Emergency Medicine (Licence: GA 94276) | |
| 207P00000X Emergency Medicine (Licence: KS 0449744) | |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2026-02-10 |