| NPI | 1316068125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246Z00000X Specialist/Technologist, Other (Licence: VA 204112N) |
| Additional Taxonomies | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
| 171000000X Military Health Care Provider | |
| 246Z00000X Specialist/Technologist, Other (Licence: VA 490166) | |
| 247200000X Technician, Other | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2022-05-13 |