| NPI | 1669870770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171W00000X Contractor | |
| 172A00000X Driver | |
| 172V00000X Community Health Worker | |
| 302F00000X Exclusive Provider Organization | |
| 305S00000X Point of Service | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2014-12-06 |
| Last Update Date | 2014-12-06 |