| NPI | 1639909112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WA 61184320) |
| Additional Taxonomies | 282E00000X (Licence: WA 61184320) |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-08-07 |