| NPI | 1235553710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 247200000X Technician, Other | |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2014-02-10 |