| NPI | 1376107987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AK 203398) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WA LP00047239) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2023-06-24 |