| NPI | 1134502693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC6688) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LGP5692) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2022-11-30 |