| NPI | 1235997297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: KY 2057013) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AL 2-077782) |
| Enumeration Date | 2024-03-13 |
| Last Update Date | 2024-03-13 |