| NPI | 1205371101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: VA 002052748) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN151580L) |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2016-12-30 |