| NPI | 1952339251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA G58518) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 192120) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NH 19078) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2021-02-05 |