| NPI | 1891496246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102209139) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102209139) |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2026-06-06 |