NPI | 1184379828 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 171000000X Military Health Care Provider |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102208040) |
208000000X Pediatrics (Licence: VA 0102208040) | |
Enumeration Date | 2022-02-21 |
Last Update Date | 2024-11-17 |