| NPI | 1104222694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: CO PN.0045773) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CO IV.0013111) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2014-11-10 |