| NPI | 1356772693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN078336) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 043108083) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-12 |