| NPI | 1164621504 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 172V00000X Community Health Worker | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2007-07-16 | 
| Last Update Date | 2017-03-28 |