| NPI | 1912679028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: DC 0910048513) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: DC NA0000811468) |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2021-09-28 |