| NPI | 1235267790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X (Licence: WY 11689800) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: WY 21878) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |