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 |