| NPI | 1194857755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD 11151) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: DC LC303599) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2007-07-08 |