| NPI | 1063056323 |
|---|---|
| Former Name | SANDRA LYNN MOON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: TX NA06663692) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |