| NPI | 1104063528 |
|---|---|
| Former Name | NISSA NICOLE JACOBSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2009-01-08 |