| NPI | 1881979615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CO 200627) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: CA 484099) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2026-04-09 |