| NPI | 1073376182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251T00000X PACE Provider Organization |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-01 |