| NPI | 1366020778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MA LN67205) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NH LN67205) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2021-03-30 |