| NPI | 1366683583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AK 6518) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: HI LPN 14579) |
| 164X00000X Licensed Vocational Nurse (Licence: CA VN 188489) | |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-03-18 |