NPI | 1124748678 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1710I1002X Military Health Care Provider, Independent Duty Corpsman (Licence: CA 1124748678) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2022-09-02 |
Last Update Date | 2023-09-16 |