| NPI | 1497323893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: CT 040861) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-06-14 |