| NPI | 1649692393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OK 8317300) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 8317300) |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2014-01-15 |