| NPI | 1013383389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: NC 430616) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: WV 0214-67133) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2015-08-20 |