| NPI | 1245609239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: TX 170552) |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site (Licence: TX 170552) |
| Enumeration Date | 2015-09-19 |
| Last Update Date | 2015-09-19 |