| NPI | 1811990310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2018-0810) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35073115) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2020-03-10 |