| NPI | 1730151010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 2159) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 2159) |
| 207Q00000X Family Medicine (Licence: PA 05-009868-L) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2020-04-01 |