| NPI | 1831782812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0102207355) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0102207355) |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2024-01-31 |