| NPI | 1134821093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102208688) |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2025-01-02 |