| NPI | 1104600212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MA LN101727) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CT 044206) |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-08-21 |