| NPI | 1821805201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: ND L18143) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MN 825332) |
| Enumeration Date | 2024-12-18 |
| Last Update Date | 2024-12-18 |