| NPI | 1144968009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101282026) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101282026) |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2022-05-21 |
| Last Update Date | 2025-10-07 |