| NPI | 1487267266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: ID PN8104) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: ID 8104) |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-08-31 |