| NPI | 1700534492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WV 41366) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN320463) |
| 164W00000X Licensed Practical Nurse (Licence: NY 349397) | |
| Enumeration Date | 2022-03-12 |
| Last Update Date | 2024-09-28 |