| NPI | 1598249930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MA LN96773) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TX 343960) |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2018-09-21 |