| NPI | 1356918395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN058974) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 957154) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2021-06-08 |