| NPI | 1811251507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 57114) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 65331-20) |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: MN 57114) | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2019-05-13 |