| NPI | 1639231608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: GA CSW003507) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: GA CSW003507) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2023-05-31 |