| NPI | 1215539689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AL 2-073401) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MS 337543) |
| Enumeration Date | 2020-11-11 |
| Last Update Date | 2020-11-11 |