| NPI | 1265909774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: TN LPN0000085703) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TN 85703) |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2018-11-01 |