| NPI | 1962775890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
| Additional Taxonomies | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians (Licence: 1962775890) |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2023-08-01 |