| NPI | 1013652965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MA LN87169) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: MA LN87169) |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2022-05-04 |