| NPI | 1245614072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MT 26343) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: HI 0215-05) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2015-07-10 |