| NPI | 1205080942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703104044) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AZ LP040316) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2022-04-26 |