| NPI | 1790075513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171WV0202X Contractor, Vehicle Modifications | |
| 172A00000X Driver | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-12-08 |