| NPI | 1639919897 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator | 
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WI 327673-31) | 
| Enumeration Date | 2024-05-27 | 
| Last Update Date | 2024-05-27 |