| NPI | 1043012966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX BP10097394) |
| Enumeration Date | 2025-03-24 |
| Last Update Date | 2026-06-19 |