| NPI | 1902514219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: TX 1475-0421) |
| Additional Taxonomies | 172A00000X Driver (Licence: TX 14589968) |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2022-11-07 |