| NPI | 1336787076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MN 80979-3) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA VN703557) |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2019-12-12 |