| NPI | 1497095665 |
|---|---|
| Former Name | GENNIENE LYNETT SIMON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2015-09-03 |