| NPI | 1376751719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5168365) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IA P22886) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-07-08 |