| NPI | 1861293904 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OR LPN10042105) | 
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL PN5245304) | 
| Enumeration Date | 2025-03-24 | 
| Last Update Date | 2025-03-24 |