| NPI | 1598111361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN089480) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NJ 26NP06965400) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |