| NPI | 1790282994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC10383) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LGP8570) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2020-04-07 |