| NPI | 1881683712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101233459) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101233459) |
| 207P00000X Emergency Medicine (Licence: KY 0101233459) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2014-12-05 |