| NPI | 1629098876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 21206) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 207Q00000X Family Medicine (Licence: NE 21602) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NE 21206) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-04-14 |