| NPI | 1639591597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WY 8035) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: WA NC60262651) |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2014-01-13 |