| NPI | 1225063415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN069094) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 277502-1) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2007-07-08 |