| NPI | 1386010577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: TX 341972) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI 4703088945) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2019-01-07 |