| NPI | 1699539502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA OL61573548) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-07-24 |