| NPI | 1275898330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: MA 4186) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: MA 4186) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2012-07-05 |