| NPI | 1144854977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: VA 0101273896) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101273896) |
| 208D00000X General Practice (Licence: VA 0101273896) | |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2025-09-25 |