| NPI | 1790774362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-11413) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2001004533) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2018-10-01 |