| NPI | 1124728100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MS p319908) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: LA 20162460) |
| Enumeration Date | 2023-03-07 |
| Last Update Date | 2023-03-07 |