| NPI | 1730722075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA 958) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2019-10-18 |
| Last Update Date | 2021-07-30 |