| NPI | 1073198024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MA LN52079) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NH 017543-22) |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2021-03-11 |