| NPI | 1013437268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102208415) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 7934) |
| 171000000X Military Health Care Provider (Licence: NE 1946) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2024-09-09 |