| NPI | 1720150741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC1126) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0701003222) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-08 |