| NPI | 1023206190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MS P317693) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AL 2-051611) |
| Enumeration Date | 2007-10-13 |
| Last Update Date | 2007-10-13 |