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 | 2011-10-12 |