| NPI | 1851923338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: LA 242464) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OR 201905312LPN) |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2020-02-12 |