| NPI | 1124768155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA PVSAWXIBZDKRYULJ) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2023-02-23 |