| NPI | 1962847459 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 267505)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267505)  | 
| Enumeration Date | 2013-05-09 | 
| Last Update Date | 2016-08-10 |