| NPI | 1750949657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 1750949657) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101271071) |
| 171000000X Military Health Care Provider (Licence: VA 1750949657) | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2023-06-23 |