| NPI | 1174765093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 12285A) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA 20A11115) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2023-10-27 |