| NPI | 1962912485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2017-10-11 |