NPI | 1215430061 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 171000000X Military Health Care Provider (Licence: VA 0102206832) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102206832) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-03-16 |
Last Update Date | 2024-06-07 |