| NPI | 1043949373 |
|---|---|
| Professional Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2023-09-19 |