| NPI | 1093821019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: GA 56647) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: GA 056647) |
| 171000000X Military Health Care Provider (Licence: GA 56647) | |
| 207Q00000X Family Medicine (Licence: GA 056647) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2025-09-29 |