| NPI | 1194179184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN880241) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: LA 750024) |
| Enumeration Date | 2016-04-16 |
| Last Update Date | 2016-04-16 |