| NPI | 1497299226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MO 053854) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 043.088452) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2016-12-13 |