| NPI | 1770290843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5217953) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL 339304) |
| Enumeration Date | 2022-10-28 |
| Last Update Date | 2022-10-28 |