| NPI | 1295076008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MN 74034-4) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WI 316037-31) |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2013-03-05 |