| NPI | 1770970642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102204655) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0102204655) |
| Enumeration Date | 2015-04-18 |
| Last Update Date | 2022-07-01 |