| NPI | 1508267170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MO 2014024403) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: KS 24-45787-071) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |