| NPI | 1326607300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NE 2281) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: NE 2281) |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2023-11-17 |