| NPI | 1053827105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MS 329864) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI 4703114738) |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2018-03-17 |