| NPI | 1700590270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246Z00000X Specialist/Technologist, Other |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2024-09-18 |