| 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 |