| NPI | 1245462951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians (Licence: VA J3ALR4N051C) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2009-08-13 |