| NPI | 1104228626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC6122) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LGP5325) |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2024-07-17 |