| NPI | 1407094386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: HI 15303) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NC 058381) |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2009-01-30 |