| NPI | 1992266050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2020029599) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2025-03-31 |