| NPI | 1346790409 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 174400000X Specialist (Licence: ID PT-3655) | 
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: NC P12822) | 
| Enumeration Date | 2016-10-12 | 
| Last Update Date | 2016-10-12 |