NPI | 1194392639 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: MA 116xtn) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MA LN61752) |
Enumeration Date | 2021-06-04 |
Last Update Date | 2021-06-07 |