| NPI | 1316194962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WV 25712) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: KY 2038039) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2008-08-26 |