| NPI | 1790243830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5177062) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: VT 025.0128559) |
| 164W00000X Licensed Practical Nurse (Licence: GA LPN094988) | |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2019-03-07 |