| NPI | 1972139913 |
|---|---|
| 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 |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01086403A) | |
| Enumeration Date | 2020-03-22 |
| Last Update Date | 2024-05-22 |