| NPI | 1457096349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MS 337432) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2022-05-04 |