| NPI | 1114374279 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA 253052) | 
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA VN253052) | 
| Enumeration Date | 2016-05-18 | 
| Last Update Date | 2020-11-16 |