| NPI | 1124648597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: CA A191071) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 207R00000X Internal Medicine (Licence: CA A191071) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-25 |
| Last Update Date | 2025-08-26 |