| NPI | 1235751439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0101279324) |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2025-03-25 |