| NPI | 1881166809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: TN 42702) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: TN 5965) |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2019-01-02 |