| NPI | 1487239422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: TX T8776) |
| 208D00000X General Practice (Licence: TX T8776) | |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2023-08-07 |