| NPI | 1154573921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: FL 10663) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: GA 000754) |
| 314000000X Skilled Nursing Facility (Licence: MA 1211) | |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2008-10-10 |