| NPI | 1427552033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101267497) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0101267497) |
| 208000000X Pediatrics (Licence: VA 0101267497) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101267497) | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2024-07-08 |