| NPI | 1154870780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401016417) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2019-05-16 |