| NPI | 1841258654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME95479) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00026986) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2021-12-13 |