| NPI | 1164813986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 010491) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: CT PTN.0012681) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2020-02-28 |