| NPI | 1114773496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: OH TC556256) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OH TC556256) |
| Enumeration Date | 2024-04-26 |
| Last Update Date | 2024-04-26 |