| NPI | 1235352907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA PN078300L) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA VN113341) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |