| NPI | 1770307936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: ND L10558) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND L10558) |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2024-11-13 |