| NPI | 1588015028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AL 2-053007) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MO 2014040799) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2016-06-27 |