| NPI | 1265187041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: TX 008950586) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: TX 0008950856) |
| Enumeration Date | 2022-02-19 |
| Last Update Date | 2022-02-19 |