| NPI | 1104616481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703121239) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 251E00000X Home Health | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2025-05-09 |
| Last Update Date | 2025-05-09 |