| NPI | 1679962971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: FL 25770971) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: OH 0091132) |
| Enumeration Date | 2015-01-10 |
| Last Update Date | 2015-01-10 |