| NPI | 1912900069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO SW001305) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 041690) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2007-07-08 |