| NPI | 1487985792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: CO 46819) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OK 0055235) |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2010-01-26 |