| NPI | 1679051692 |
|---|---|
| Former Name | KYLIE TAMIKO GUMBAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2021-03-29 |