| NPI | 1083962914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WY 6157) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2012-08-27 |