| NPI | 1104583335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: FL 405443) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: FL 1922196) |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2021-11-22 |