| NPI | 1790386845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 347C00000X Private Vehicle |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |