| NPI | 1093978918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 23730) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2025-07-15 |