| NPI | 1982683645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 27014) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 33692) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: HI MD-9100) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2021-04-01 |