| NPI | 1700571155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: KS 42777) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 043.123805) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-04-10 |