| NPI | 1942638309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: NY 610975) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: NY 610975) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2013-10-23 |