| NPI | 1891327094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0077228) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 101272614) |
| 171000000X Military Health Care Provider (Licence: VA 101272614) | |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2026-04-15 |