| NPI | 1295374957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MS 335553) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MS 332392) |
| Enumeration Date | 2019-12-29 |
| Last Update Date | 2019-12-29 |