| NPI | 1164870101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: FL 234446) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: FL 253ZOOOOOX) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |