| NPI | 1821202045 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101245315)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116018605)  | 
| Enumeration Date | 2007-05-09 | 
| Last Update Date | 2009-07-30 |