| NPI | 1740635705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: NC 32001509) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: NC 32001509) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |