| NPI | 1558488510 |
|---|---|
| Former Name | ANGELA LIGHT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IN 31004126a) |
| Additional Taxonomies | 286500000X Military Hospital (Licence: IN 31004126a) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2014-07-16 |