| NPI | 1215011671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN072185) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WA LP00053625) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-07-08 |