| NPI | 1558909903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: VA 0002088365) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI TMSH000109) |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2019-12-17 |