| NPI | 1467801563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: ME LPN12729) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TX 319219) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-06-09 |