| NPI | 1255683967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NC 73712) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 280956-1) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2012-10-04 |