| NPI | 1407159304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: PA TE008638) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: FL PTA 19957) |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2010-12-15 |