| NPI | 1225715287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 172A00000X Driver (Licence: NY 468335299) |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2023-07-04 |