| NPI | 1184877995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703058626) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NV lpn1153) |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2008-10-24 |