| NPI | 1265211163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172A00000X Driver (Licence: ND ROS-81-7758) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: ND 00000) |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2023-09-28 |