| NPI | 1982299434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102207481) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0102207481) |
| Enumeration Date | 2021-03-06 |
| Last Update Date | 2025-06-25 |