| NPI | 1902499288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A180703) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2022-07-28 |