| NPI | 1235474479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WI 315473-31) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: WI 282468) |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2012-11-28 |