| NPI | 1568860351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MA LN64803) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: MA PT4516) |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2014-12-11 |