NPI | 1306367446 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5187723) |
Additional Taxonomies | 251E00000X Home Health (Licence: FL 5187723PN) |
Enumeration Date | 2017-06-28 |
Last Update Date | 2017-06-28 |