| NPI | 1851839179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ 252715) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA VN 686576) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2022-02-13 |