| NPI | 1952818742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WI 313235) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TX 308327) |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2018-01-08 |