| NPI | 1487234613 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5239135) |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 174H00000X Health Educator | |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2021-04-12 |