| NPI | 1740471077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 37739) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 37739) |
| 207P00000X Emergency Medicine (Licence: VA 0102202037) | |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2019-09-18 |