| NPI | 1275807380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: IL 043.090149) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WI 303882-31) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |