| NPI | 1063057651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GU LX0639) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 713340) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2024-01-04 |