| NPI | 1215496948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OR 2018090389LPN) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WA LP60253670) |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-03-31 |