| NPI | 1619249075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: SD 1113) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: IA 13217) |
| 314000000X Skilled Nursing Facility (Licence: NE 2522) | |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-02-01 |