| NPI | 1134705569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MO 2009021248) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: MO 2019008294) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-03-24 |