| NPI | 1417460015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MS 331694) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MS 334558) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2017-11-06 |