| NPI | 1073231684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: LA 1111111) |
| Enumeration Date | 2022-08-19 |
| Last Update Date | 2023-05-04 |