| NPI | 1104548536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: WI WI031910101915) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: WI 00197312) |
| Enumeration Date | 2022-09-13 |
| Last Update Date | 2022-09-13 |