| NPI | 1821789272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1710I1002X Military Health Care Provider Independent Duty Corpsman |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-05-22 |