| NPI | 1871940015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 151619) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2023-08-22 |