| NPI | 1992378186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: LA 86-3845506) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: LA 86-3845506) |
| 374U00000X Home Health Aide (Licence: LA 86-3845506) | |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2021-08-05 |