| NPI | 1467629980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
| 171000000X Military Health Care Provider | |
| 1710I1002X Military Health Care Provider, Independent Duty Corpsman | |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2021-09-29 |