| NPI | 1609319763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care (Licence: FL 9143) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 1697752) |
| 163WA2000X Registered Nurse, Administrator (Licence: FL 1697752) | |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2020-01-16 |