| NPI | 1215760467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AK 190355) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 328268) |
| Enumeration Date | 2024-08-22 |
| Last Update Date | 2024-08-22 |