| NPI | 1821258567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P0041) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101017767) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101017767) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2018-03-01 |