| NPI | 1053880427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care (Licence: AR 186) |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider (Licence: AR Ar5555) |
| 385H00000X Respite Care (Licence: AR Ar5555) | |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2019-05-30 |