| NPI | 1952923344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2024001182) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2025-05-30 |