| NPI | 1306861836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WI 17019-031) |
| Additional Taxonomies | 183700000X Pharmacy Technician |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-07-08 |