| NPI | 1194597146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WV 83952) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WV 57137) |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2023-10-24 |