NPI | 1497299226 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MO 053854) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 043.088452) |
Enumeration Date | 2016-12-13 |
Last Update Date | 2016-12-13 |