| NPI | 1104216829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: DC LPN1007642) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: VA 0002089348) |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-02-02 |