| NPI | 1942547641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MS 335925) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN285379) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2019-05-14 |