| NPI | 1538550090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA 072012) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AL 2-063133) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2015-02-05 |