| NPI | 1811950090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 75062) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2021-03-05 |