| NPI | 1609340660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WA LP60500714) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OR 201810289LPN) |
| Enumeration Date | 2019-01-13 |
| Last Update Date | 2019-01-13 |