| NPI | 1386092054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WA 60335580) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA 09569369) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2016-06-02 |