| NPI | 1245033471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58.03828) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: OH 58.03828) |
| Enumeration Date | 2025-03-31 |
| Last Update Date | 2025-08-18 |