| NPI | 1851929566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101272953) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0101272953) |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2023-08-18 |