| NPI | 1669555686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1710I1002X Military Health Care Provider, Independent Duty Corpsman |
| Additional Taxonomies | 246Y00000X Spec/Tech, Health Info |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2024-04-22 |