| NPI | 1205155140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MA LN85394) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CT 031410) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2010-05-17 |