| NPI | 1912311192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 12013387-1204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS018133) |
| 207P00000X Emergency Medicine (Licence: NY 297774-01) | |
| 207Q00000X Family Medicine (Licence: PA OS018133) | |
| 207Q00000X Family Medicine (Licence: UT 12013387-1204) | |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2021-11-02 |