| NPI | 1790339224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-08-01 |