| NPI | 1295010619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OR 200830328LPN) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AL 2-062804) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2011-10-17 |