| NPI | 1669913497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101265171) |
| Additional Taxonomies | 286500000X Military Hospital |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: VA 0101265171) | |
| 171000000X Military Health Care Provider (Licence: VA 0101265171) | |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2026-04-30 |