| NPI | 1194163550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 1236) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NE 1236) | |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2020-01-13 |