| NPI | 1104227834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN080991) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AR L048721) |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2014-09-12 |