| NPI | 1811222177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: NY 004799-1) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: NY 004799-1) |
| 251E00000X Home Health (Licence: NY 004799-1) | |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2009-10-05 |