| NPI | 1104485911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC12625) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LGP9486) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2022-05-05 |