| NPI | 1912421074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: TN 56055) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TN 86055) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2022-07-21 |