| NPI | 1508626896 |
|---|---|
| Former Name | MICHAELA BRIANNE WARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101287174) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2025-08-26 |