| NPI | 1013268010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WY 7864) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CO 0330453) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |