| NPI | 1962795674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34011756) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 2801) |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2022-04-06 |