| NPI | 1861038093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5146030) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 253Z00000X In Home Supportive Care | |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2019-11-22 |