NPI | 1346650686 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171000000X Military Health Care Provider |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2015-01772) |
Enumeration Date | 2014-05-07 |
Last Update Date | 2022-06-21 |