| NPI | 1336857853 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NE 27532) | 
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 709590) | 
| Enumeration Date | 2022-11-14 | 
| Last Update Date | 2022-11-14 |