| NPI | 1053634972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: KS 17-02516) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: MO 2008015794) |
| Enumeration Date | 2010-03-05 |
| Last Update Date | 2010-03-05 |