NPI | 1639394273 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: IL 043.075406) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: IL 370984175) |
Enumeration Date | 2007-04-17 |
Last Update Date | 2007-07-08 |