| NPI | 1104297308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2020-12-16 |