| NPI | 1295282549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MD LP35921) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN25854L) |
| Enumeration Date | 2016-09-03 |
| Last Update Date | 2016-09-03 |