| NPI | 1215387865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 30289) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2024-09-12 |