| NPI | 1356604862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 775361) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: NY 19223) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2012-06-19 |