| NPI | 1255195657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102209456) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2025-09-19 |