| NPI | 1013559301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 231476) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2023-12-14 |