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 |