| NPI | 1043810682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC12774) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LGP10574) |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2023-06-20 |