| NPI | 1174995401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN 084739) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL Pn 5203077) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-10-26 |