| NPI | 1174758635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703101737) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MO 049685) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2009-05-27 |