| NPI | 1033454798 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OR 201230326LPN)  | 
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 249437)  | 
| Enumeration Date | 2012-12-06 | 
| Last Update Date | 2012-12-06 |