Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 0024177798 | VA |
NPI | 1144838517 |
---|---|
Provider Name | Josephine Kariuki |
First Address | Fort Bragg, NC 28310-7324 |
Second Address | Fort Bragg, NC 28310-7324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2020 |
Last Update Date | 21/07/2020 |