| NPI | 1114760436 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA PN297503) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9610147) | 
| Enumeration Date | 2024-06-14 | 
| Last Update Date | 2024-08-06 |