| NPI | 1215111760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MA 50095) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: MA 50095) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-19 |