| NPI | 1396360699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747A0650X Technician Attendant Care Provider |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2020-06-11 |