| NPI | 1477242485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 123456789) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 001234567) |
| Enumeration Date | 2023-05-04 |
| Last Update Date | 2023-05-04 |