NPI | 1649806126 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: NC 2021-02404) |
Additional Taxonomies | 171000000X Military Health Care Provider |
Enumeration Date | 2020-03-17 |
Last Update Date | 2023-08-17 |