| NPI | 1487939351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WI 31202) |
| Additional Taxonomies | 3747A0650X Technician Attendant Care Provider (Licence: WI 31202) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2011-10-11 |