| NPI | 1568013019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376G00000X Nursing Home Administrator (Licence: FL 171240343) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL 5178725) |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2019-09-26 |