| NPI | 1619799608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL pn5255451) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: KY pn5255451) |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2024-10-30 |