NPI | 1366899791 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ TLP051832) |
Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA VN189908) |
Enumeration Date | 2016-05-16 |
Last Update Date | 2016-05-16 |