| NPI | 1174091615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MO 2014030853) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: E3268701) |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2018-11-02 |