| NPI | 1003301813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WA 60860936) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IN 27059750A) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |