| NPI | 1356588123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver (Licence: CA CA #0367076) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: CA CA# 0367076) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |