| NPI | 1235587981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6851115983) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2023-01-03 |