| NPI | 1447784483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MD 41878) |
| Additional Taxonomies | 3747A0650X Technician Attendant Care Provider (Licence: MD 41878) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |