| NPI | 1255995296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AK 154363) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 232364-1) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2019-12-03 |