| NPI | 1447724398 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC10727)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LGP8938)  | 
| Enumeration Date | 2019-01-14 | 
| Last Update Date | 2024-01-15 |