| NPI | 1205207230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN089552) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AL 2-066405) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2015-10-16 |