| NPI | 1124440284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MD LP43457) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN274636) |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2014-01-09 |