| NPI | 1013280718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: VA 0102203540) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102203540) |
| Enumeration Date | 2012-02-12 |
| Last Update Date | 2023-11-07 |