| NPI | 1861804056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2015036883) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 29957) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2021-04-06 |