| NPI | 1205361953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: 64658862) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: 64658862) |
| 374U00000X Home Health Aide (Licence: 64658862) | |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2020-01-30 |