| NPI | 1578773040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ LP028685) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA VN167321) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-07-08 |