| NPI | 1780126649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MO 2010036132) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WA N160704104) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-09 |