| NPI | 1790170280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 63361) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 68935-20) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2021-11-10 |