| NPI | 1407591472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA 754775) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00149858) |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2022-05-25 |