NPI | 1700458254 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MO 2012032038) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 043125358) |
Enumeration Date | 2021-07-14 |
Last Update Date | 2021-07-14 |