NPI | 1871120774 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101272941) |
Additional Taxonomies | 171000000X Military Health Care Provider |
Enumeration Date | 2020-03-23 |
Last Update Date | 2024-03-13 |