| NPI | 1629646823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: NV 20201858002) |
| Additional Taxonomies | 171400000X Health & Wellness Coach (Licence: NV 20201858002) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-06-14 |