| NPI | 1326060591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN039337) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: GA PTA001335) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-08 |