| NPI | 1821858689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0102209544) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: 1821858689) |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2025-09-10 |