| NPI | 1447505672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101283425) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0101283425) |
| 231H00000X Audiologist (Licence: NJ 41YA00083200) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2024-08-01 |