| NPI | 1992596563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 00000000000000000) |
| Enumeration Date | 2025-05-14 |
| Last Update Date | 2025-06-17 |