| NPI | 1669969424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 32231) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: NE 32231) |
| 208D00000X General Practice (Licence: NE 32231) | |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2026-03-03 |