| NPI | 1164871612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC8367) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: DC PRC14861) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2019-02-26 |