| NPI | 1043079635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: TX 13146) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: TX 1175-0313) |
| Enumeration Date | 2024-03-15 |
| Last Update Date | 2024-03-15 |