| NPI | 1508030818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA PN278757) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 286990-1) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2008-04-17 |