| NPI | 1114613536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X (Licence: AZ 1703) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: AZ 1703) |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-18 |