| NPI | 1487904900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN076041) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL PN5165554) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2012-09-12 |