| NPI | 1679255509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374K00000X Religious Nonmedical Practitioner (Licence: IL 9910) |
| Additional Taxonomies | 374K00000X Religious Nonmedical Practitioner |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2023-08-01 |