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 |