| NPI | 1891106969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: FL 172V00000X) |
| Additional Taxonomies | 172A00000X Driver (Licence: FL 172A00000X) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2014-05-12 |