| NPI | 1538356720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: FL MA67407) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: FL 692013696) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2015-10-28 |