| NPI | 1902962343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906031) |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider (Licence: FL 9000015076) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2007-07-08 |