| NPI | 1720620768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 240690) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 0011428) |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-10 |