| NPI | 1972929719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: TX 00142) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: TX 00142) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2014-03-17 |