| NPI | 1467887372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: MA 1541) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: AZ 5550) |
| 172V00000X Community Health Worker (Licence: MA OTA00058) | |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2013-09-10 |