| NPI | 1700308582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AL 2-59584) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CO PN.0334038) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2017-08-24 |