| NPI | 1518769439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 208D00000X General Practice (Licence: NV SL2336) |
| Enumeration Date | 2025-03-24 |
| Last Update Date | 2025-06-26 |