| NPI | 1679385967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: ND 13150) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MN 409711) |
| Enumeration Date | 2025-01-23 |
| Last Update Date | 2025-01-23 |