| NPI | 1205236759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN089447) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: HI 15018) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-02 |