| NPI | 1962991836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0101267521) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2022-05-09 |