| NPI | 1104544683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: TX na0060054910) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: TX 1688-0822) |
| Enumeration Date | 2022-08-19 |
| Last Update Date | 2022-08-19 |