| NPI | 1134754096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: ID M-16050) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: ID M-16050) |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2023-12-20 |