| NPI | 1235536418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AL 2-050593) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: VA 0002068646) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |