NPI | 1609100767 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: GA LPN081015) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH pn-110219) |
Enumeration Date | 2009-09-22 |
Last Update Date | 2016-10-21 |