| NPI | 1881252898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101270647) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0101270647) |
| 208D00000X General Practice (Licence: VA 0101270647) | |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2025-08-26 |