| NPI | 1104591908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MA LN93801) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN10010454) |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2024-08-05 |