| NPI | 1295164945 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 174400000X Specialist (Licence: MA8493)  | 
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: MA8493)  | 
| Enumeration Date | 2013-11-04 | 
| Last Update Date | 2013-11-04 |