| NPI | 1891803599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H0060072) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 65060) |
| 207P00000X Emergency Medicine (Licence: WV 2180) | |
| 207Q00000X Family Medicine (Licence: MD D36761) | |
| 207Q00000X Family Medicine (Licence: WV 2180) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2019-03-21 |