| NPI | 1750329777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60031114) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 241321-1) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2016-08-10 |