| NPI | 1164904660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AL 2-054230) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OR 201707302) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2018-08-30 |