| NPI | 1841902731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102209162) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0102209162) |
| 208D00000X General Practice (Licence: VA 0102209162) | |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2022-12-22 |
| Last Update Date | 2025-05-23 |