| NPI | 1003052077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN 085421) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 123026) |
| Enumeration Date | 2008-12-23 |
| Last Update Date | 2016-10-07 |