| NPI | 1760748552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2026-08-28 |