| NPI | 1215358601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AK 7030) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WA LP00032964) |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2014-01-02 |