| NPI | 1013103654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN064421) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL PN5160927) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2007-09-18 |