| NPI | 1376991661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN 5186694) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN 274642) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2016-05-27 |