| NPI | 1962042531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-01-13 |