| NPI | 1639876766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: ND 00000) |
| Additional Taxonomies | 172A00000X Driver (Licence: ND wah-87-4552) |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2023-02-09 |