| NPI | 1700417110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MS 341934) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2025-01-08 |