| NPI | 1104028356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: DC LPN8074) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MD LP30356) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2007-07-08 |