| NPI | 1174824023 |
|---|---|
| Former Name | NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: TX 172V00000X) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2010-11-09 |