| NPI | 1164879250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9425064) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL pn5180818) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2016-05-18 |