| NPI | 1114303260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172A00000X Driver (Licence: GA 058510994) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171W00000X Contractor | |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2015-07-30 |