| NPI | 1487251443 |
|---|---|
| Former Name | ILONA KIKNADZE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: TX 323953) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 275342) |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2020-10-02 |