| NPI | 1902508070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102210225) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2026-06-16 |