| NPI | 1649583055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA PN083412L) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NJ 26NP02532200) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2010-07-15 |