| NPI | 1306549746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CO DR.0074573) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2025-03-13 |