| NPI | 1255047627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC NA) |
| Enumeration Date | 2023-01-27 |
| Last Update Date | 2023-02-01 |