| NPI | 1316335177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ LP045817) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL PN5215182) |
| Enumeration Date | 2015-01-02 |
| Last Update Date | 2015-01-02 |