| NPI | 1104698299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5241736) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WA LP61415978) |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2024-04-07 |