| NPI | 1912562372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AK 144109) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: WA 0019084) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-09-24 |