| NPI | 1265612287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 12581) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MD P13168) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |