| NPI | 1104183854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC4827) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LGP3491) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2020-08-06 |