| NPI | 1447989306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC 0000000000) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2023-10-03 |