| NPI | 1619294022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: MO 2002003056) |
| Additional Taxonomies | 251E00000X Home Health (Licence: KS 1492980041) |
| Enumeration Date | 2010-04-24 |
| Last Update Date | 2010-04-24 |