| NPI | 1871052894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AK 144811) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MD LP52199) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2019-05-31 |