| NPI | 1902961220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VT 0680000502) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MA 4255) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2007-07-08 |