| NPI | 1144821844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AK 168612) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TN 80840) |
| Enumeration Date | 2020-11-08 |
| Last Update Date | 2021-02-08 |