| NPI | 1447693593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 208D00000X General Practice (Licence: MO 2014026584) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2020-12-30 |