| NPI | 1235501693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AL 2066467) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MS P324855) |
| 164W00000X Licensed Practical Nurse (Licence: HI LPN16824) | |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-10-26 |