| NPI | 1811241748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LPC-5855) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2015-06-10 |