| NPI | 1790910628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD201607) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301 094 181) |
| 207P00000X Emergency Medicine (Licence: FL ME142519) | |
| 207P00000X Emergency Medicine (Licence: WI 56902) | |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2021-01-14 |