| NPI | 1770103301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT229945) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: CO DR.0066744) |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2023-06-26 |