| NPI | 1720582448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CO DR.0063023) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: CO DR.0063023) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CO DR.0063023) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO DR.0063023) | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2025-06-26 |