| NPI | 1679962468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 286500000X Military Hospital (Licence: GA LPN090279) |
| Additional Taxonomies | 286500000X Military Hospital (Licence: MA LN58812) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |