| NPI | 1093064768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MO 2012014436) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2014039693) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2014-12-17 |