| NPI | 1013420108 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: DC LPN1004120) | 
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MD LP43275) | 
| Enumeration Date | 2017-11-10 | 
| Last Update Date | 2017-11-10 |