| NPI | 1548704919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 249907) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: GA LPN087768) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2016-12-05 |