| NPI | 1972827830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO 2013020319) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VI 2479) |
| 207Q00000X Family Medicine (Licence: IL 036134631) | |
| 207Q00000X Family Medicine (Licence: FL ME117446) | |
| 207Q00000X Family Medicine (Licence: MO 2013020319) | |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2018-09-12 |